Eating Disorders and Body Image For Trans People
Transgender people, like myself, are people who identify as any gender other than the sex they were assigned at birth – this includes transmen, transwomen, and non-binary genders (i.e., people who identify as neither strictly male nor female). While there appears to be no official statistics, it is thought that there were approximately 500,000 transgender people in the UK in 2018 (Government Equalities Office, 2018) and research has shown that a very large proportion of the transgender population experience struggles with mental health issues, including eating disorders. Despite this, very little mental health research has focused on transgender communities and why prevalence rates might be so high.
Along with the majority of transgender people, I experience gender dysphoria, which is a discomfort caused by the conflict between biological sex and gender identity. Gender dysphoria can thankfully be reduced over time through social and medical transitioning. However, due to the amount of time and difficulty to transition, dysphoria can have a massive negative impact on how trans people view their bodies. This in turn can often begin to affect the relationship that trans people have with food and exercise.
The gender a trans person identifies as, or the gender they were assigned at birth, may impact the way in which their relationship with their body is affected or the nature of their relationship with food. Just as media influences the desired body shapes for cisgender people (people who identify with the gender they were assigned at birth), it can lead to trans people desiring the extremes of a ‘masculine’ or ‘feminine’ body in an attempt to ‘pass’ as the gender they identify as. Equally, rather than influencing their body towards the stereotype of their identified gender, trans individuals may attempt to simply change their body to reflect the opposite of the stereotyped shape of their gender assigned at birth.
Societal pressures on top of gender dysphoria can lead to a confusing relationship with your body, leading to unhealthy eating habits or exercise regimes. As I identify as non-binary, I cannot speak fully about the trans male or trans female experience. However, through involvement in transgender communities, it appears common for transwomen to often desire slimmer or curvier bodies that match the cisgender women represented in media, and so this may lead to restricting food intake and an increase in exercise. However, transwomen may also want to avoid muscular bodies that are typically associated with masculinity and so this may equally discourage physical activity, potentially further increasing the severity of food restriction in an attempt to lose weight without exercise. Alternatively, transmen may adopt extreme exercise regimes and change their diets to become more muscular and match cisgender men in the media.
Non-binary (an individual who doesn't identify as solely male or female) representation in society is very limited, however, there has been a slow increase of non-binary characters in media over the last few years. This representation remains important in normalising non-binary people; however, the media continues to mostly only portray non-binary people as androgynous (having both male and female characteristics) and slim, therefore alienating any non-binary person who doesn’t fit this criterion. Much like transmen and transwomen, the slim, non-binary people portrayed in the media create societal pressure for non-binary people to fit these ideals. However, this may cause more difficulty if attempting to appear androgynous as they may not like to appear thin in case of appearing feminine or muscular in case of appearing masculine.
Along with gender dysphoria causing many body image issues which can affect trans peoples’ diet, there are many other factors that may affect a trans person’s mental health and put them at high risk for eating disorders. Living in a society where being transgender is not accepted by everyone, facing a range of hateful reactions for simply being yourself, constantly hearing debates about whether or not you should have rights as a trans person, and having people completely deny the existence of your gender can take a massive toll on trans people’s mental health. These can all lead to the development of depression and anxiety, which research has shown to be connected to the onset of eating disorders (Goossens et al., 2009). Due to the amount of uncertainty and anxiety that comes with being transgender, many trans people may begin to change how they eat, as food intake becomes one of the few things they can feel in control of and disordered eating behaviours can arise.
Overall, much more research needs to be done into the exact cause of the high prevalence rates of eating disorders and other mental health issues in transgender people. Along with this, it is important to raise awareness of the struggles that trans people may face so that support can be put in place and stop trans people from having to feel alone with their experiences.
Goossens, L., Braet, C., Vlierberghe, L. V., & Mels, S. (2009). Loss Of Control Overeating In Overweight Youngers: The Role Of Anxiety, Depression, and Emotional Eating. European Eating Disorders Review, 17(1), 68 – 78. https://doi.org/10.1002/erv.892
Government Equalities Office. (2018). TRANS PEOPLE IN THE UK. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/721642/GEO-LGBT-factsheet.pdf